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Neurosurgery: Chordoma of the Skull Base

Chordomas are rare malignant tumors growing from embryonic remnants of the chord. In 30% cases, they are located at the base of the skull (cranial chordomas). Most cases are registered at the age of 30 to 60. To confirm the diagnosis, the patients undergo the biopsy followed by histological examination. The compulsory step in chordoma treatment is surgical removal of the tumor. Also, the radiosurgery, proton therapy and chemotherapy can be used.

Surgery

For a long time, the cranial chordoma used to be removed by craniotomy. The radicality of this method was low, and the rate of complications was high.

In modern surgery, this intervention is performed via transnasal (through the nose), or transoral (through the mouth) access, which allows reducing the injury significantly. The affected tissues are excised with microsurgical instruments without compromising the healthly brain structures. The manipulation precision is monitored using the endoscopic techniques.

When possible, the tumor is removed completely, with the capsule. However, most patients are diagnosed when the formation invaded the surrounding tissues, so surgeons must be limited to a partial resection.

Radiosurgery

The essence of radiosurgery is a single tumor irradiation with thin beams of radiation from a variety of angles. The main mass of energy is released precisely into the pathological focus, not spreading to the adjacent healthy tissues. High-dose exposure leads to destruction of the genetic apparatus of malignant cells and their gradual destruction. The procedure effects are manifested over the next 6 to 24 months.

The main indication for radiosurgery is residual postoperative tumors. This technique can be recommended as the only treatment method for small (less than 3 cm) or inoperable tumors.

Good results in patients with chordomas are produced by radiosurgical interventions using the Gamma Knife and Novalis. Both types of therapy are performed on an outpatient basis in one day.

Proton Therapy

Proton therapy is a type of radiotherapy upon which the pathological focus is affected by the beams of heavy particles, i.e. protons. Unlike x-rays, proton beams provide a maximum energy concentration in the final point of impact and substantially do not lose its when passing through healthy surface tissues. In comparison with traditional radiation, such treatment is safer and more effective.

The proton therapy is indicated to patients with chordomas in the postoperative period for destruction of residual tumor. Procedures are conducted daily for several weeks.

Chemotherapy

Anticancer drugs are used upon postoperative radiotherapy failure, or in the case of disease recurrence. The patients are prescribed such innovative drugs as tyrosine kinase inhibitors and platinum drugs.

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University Hospital Muenster

9.8/10 from 78 Votes
location_onGermany, Muenster
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Department of Neurosurgery

Surgical resection of Chordoma of the skull base #205101

The Department of Neurosurgery at the University Hospital Muenster deals with the surgical treatment of diseases of the central and peripheral nervous systems.

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Charite University Hospital Berlin

9/10 from 95 Votes
location_onGermany, Berlin
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Department of Neurosurgery and Pediatric Neurosurgery

Surgical resection of Chordoma of the skull base #210305

The Department of Neurosurgery and Pediatric Neurosurgery at the University Hospital Charite deals with the treatment of the peripheral and central nervous systems.

University Hospital Rechts der Isar of the Munich Technical University

10/10 from 70 Votes
location_onGermany, Munich
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Department of Neurosurgery

Surgical resection of Chordoma of the skull base #201835

The Department of Neurosurgery at the university hospital Klinikum rechts der Isar is a part of the newly established “Neuro-Kopf-Zentrum” since March 2007.

University Hospital of the Ludwig-Maximilians-University Munich (LMU)

9.2/10 from 40 Votes
location_onGermany, Munich
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Department of Neurosurgery

Surgical resection of Chordoma of the skull base #203651

The Department of Neurosurgery at the University Hospital of Munich focuses on personalized treatment plans tailored to the patient’s needs, which meet the highest medical and technical standards. Here, the therapy of neurosurgical diseases is performed with the help of leading technologies.

University Hospital Frankfurt am Main

10/10 from 97 Votes
location_onGermany, Frankfurt am Main
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Department of Neurosurgery

Surgical resection of Chordoma of the skull base #210791

The Department of Neurosurgery specializes in the diagnosis and treatment of neurosurgical diseases. The department has state-of-the-art neurosurgical equipment and a team of highly qualified doctors.

Sana Hospital Duisburg

9.8/10 from 5 Votes
location_onGermany, Duisburg
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Department of Neurosurgery

Surgical resection of Chordoma of the skull base #220465

The Department of Neurosurgery offers surgical treatment of neurological, neuropediatric and orbital diseases. With 68 beds, the department ranks among the largest German Neurosurgy Centers and has a long experience in all fields of microsurgery and neuroendoscopy.

HELIOS Clinic Krefeld

9.7/10 from 38 Votes
location_onGermany, Krefeld

Department of Adult and Pediatric Neurosurgery

Surgical resection of Chordoma of the skull base #385599

The Department of Adult and Pediatric Neurosurgery offers the full range of services in this medical field.

Alfried Krupp Hospital in Essen-Ruettenscheid

7.4/10 from 42 Votes
location_onGermany, Essen
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Department of Neurosurgery

Surgical resection of Chordoma of the skull base #217125

The Department of Neurosurgery at the Alfried Krupp Hospital in Essen focuses on the following tasks and areas: microsurgery, vascular brain surgery, brain tumors, skull base surgery, spinal column surgery, traumatic brain injury, peripheral nerves, pain therapy, radiosurgery.

Academic Hospital Schwabing Munich

8.5/10 from 7 Votes
location_onGermany, Munich

Department of Neurosurgery

Surgical resection of Chordoma of the skull base #204613

The Department of Neurosurgery in Schwabing treats diseases in the brain and spine. The most modern high-tech micro-surgery is used. In order to distinguish the tumour optimally, intraoperative fluorescence microscopy will be used during surgery.

Tel Aviv Sourasky Medical Center

9.9/10 from 23 Votes
location_onIsrael, Tel Aviv

Department of Neurosurgery

Surgical resection of Chordoma of the skull base #330632

The Department of Neurosurgery at the Tel Aviv Sourasky Medical Center specializes in the treatment of diseases of the brain, spinal cord and peripheral nervous system in children and adults. The Department is considered the leading neurosurgery facility in Israel and worldwide.

University Hospital Cologne

9.8/10 from 82 Votes
location_onGermany, Cologne
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Department of Neurosurgery

Surgical resection of Chordoma of the skull base #208689

The Department of Neurosurgery is the center of excellence in research and patient care. The department consists of two sections: the Section of General Neurosurgery specializing in the treatment of diseases of the nervous system and the Section of Stereotactic and Functional Neurosurgery.

Rambam Health Care Campus Haifa

9.8/10 from 23 Votes
location_onIsrael, Haifa

Department of Neurosurgery

Surgical resection of Chordoma of the skull base #327604

The Department of Neurosurgery at Rambam Health Care Campus deals with the diagnosis and treatment of the entire spectrum of diseases of the central nervous system. The Department has 32 beds, including 11 neurointensive care beds.

University Hospital for Neurosurgery Salzburg

9.6/10 from 39 Votes
location_onAustria, Salzburg

Department of Neurosurgery

Surgical resection of Chordoma of the skull base #198523

University Clinic of Neurology specializes in the surgical treatment of acute and chronic diseases of the central and peripheral nervous system, its blood supply, and nerve sheaths, as well as in preoperative and postoperative care for patients.

University Hospital Tuebingen

9.2/10 from 55 Votes
location_onGermany, Tuebingen
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Department of Neurosurgery

Surgical resection of Chordoma of the skull base #205319

The Department of Neurosurgery covers the full range of neurosurgical interventions. These include surgery of brain cancer and spinal cord tumor in children and adults, skull base and pituitary surgery, treatment of neurofibromatosis, vascular malformations / aneurysms, hydrocephalus, traumatic brai...

Clinic de Genolier Genolier

9.2/10 from 18 Votes
location_onSwitzerland, Genolier

Department of General Surgery

Surgical resection of Chordoma of the skull base #366116

Aesthetic and reconstructive surgery allows the patient to return to his or her original appearance, get rid of the age-related changes or correct some imperfections.

Academic Hospital Bogenhausen Munich

9.2/10 from 43 Votes
location_onGermany, Munich

Department of Neurosurgery

Surgical resection of Chordoma of the skull base #203989

The department of neurosurgery d specializes in the diagnosis and treatment of brain and spine diseases. Performing about 2500 surgeries annually, the department is considered one of the leading centers of neurosurgery in Germany.




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